Provider Demographics
NPI:1902223035
Name:WATTS, AMBER (FNP)
Entity Type:Individual
Prefix:MRS
First Name:AMBER
Middle Name:
Last Name:WATTS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1744 E MCANDREWS RD
Mailing Address - Street 2:STE D
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-5576
Mailing Address - Country:US
Mailing Address - Phone:541-414-0362
Mailing Address - Fax:541-200-2269
Practice Address - Street 1:691 MURPHY RD STE 107
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504
Practice Address - Country:US
Practice Address - Phone:541-789-6460
Practice Address - Fax:541-789-6461
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2021-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201709742NP-PP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner